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(Effects of a Nutrition Education Program on Physicians/Residents--continued)


APPENDICES


APPENDIX A

CURRICULUM SURVEY

 

Plans are being made for a nutrition lecture series for the Family Practice Residents at Union Hospital (Terre Haute, Indiana). Please rate each one of the topics listed below as either: E for essential, I for important, D for desirable, or NA for not appropriate for inclusion in this nutrition lecture series.

 


"E"

"I"

"D"

"NA"

(A) BIOCHEMISTRY/PHYSIOLOGY





1. GI Tract: An overview of function

_____

_____

_____

_____

2. Physiology of Hunger & Satiety

_____

_____

_____

_____

3. Nutrient Sources: (Pro, Cho, Fat, Vit, Min)

_____

_____

_____

_____

4. Lipids & Cholesterol

_____

_____

_____

_____

5. Trace Minerals & Antioxidants

_____

_____

_____

_____

6. Energy Balance

_____

_____

_____

_____

7. Water, Electrolytes, Acid/Base Balance

_____

_____

_____

_____

8. Hormonal Control of Nutrient Metabolism

_____

_____

_____

_____

(B) NUTRITION ASSESSMENT





1. Anthropometrics

_____

_____

_____

_____

2. Assessment of Nutrient Intake

_____

_____

_____

_____

3. Biochemical Evaluation

_____

_____

_____

_____

(C) WELLNESS, DIET & PREVENTION





Nutritional Aspects of:





1. Growth & Development

_____

_____

_____

_____

2. Pregnancy

_____

_____

_____

_____

3. Lactation

_____

_____

_____

_____

4. Geriatrics

_____

_____

_____

_____

5. Nutritional Supplements

_____

_____

_____

_____

6. Dietary Guidelines

_____

_____

_____

_____

7. Food Guide Pyramid

_____

_____

_____

_____

8. Vegetarian Diets

_____

_____

_____

_____

9. Infancy & Adolescence

_____

_____

_____

_____

10. National Nutrition Programs/Goals

_____

_____

_____

_____

11. Alternate Medical Programs
      (Ornish, McDougall)

_____

_____

_____

_____

12. Ethics & Feeding the Terminally Ill

_____

_____

_____

_____

13. Food Fads, & Health Food Trends

_____

_____

_____

_____


"E"

"I"

"D"

"NA"

(D) NUTRITION & DISEASE





Clinical Strategies For:





1. Liver Disease

_____

_____

_____

_____

2. Renal Disease

_____

_____

_____

_____

3. Failure to Thrive

_____

_____

_____

_____

4. Hyperlipidemia & Atherosclerosis

_____

_____

_____

_____

5. Diabetes

_____

_____

_____

_____

6. Cancer

_____

_____

_____

_____

7. Osteoporosis

_____

_____

_____

_____

8. Rheumatoid Disease

_____

_____

_____

_____

9. Allergies

_____

_____

_____

_____

10. Nutritional Anemias

_____

_____

_____

_____

11. Drug/Nutrient Interactions

_____

_____

_____

_____

12. Hospital Malnutrition

_____

_____

_____

_____

13. Surgery, Trauma & Infection

_____

_____

_____

_____

14. Wound Healing

_____

_____

_____

_____

15. Eating Disorders

_____

_____

_____

_____

16. AIDS & Immune Function

_____

_____

_____

_____

17. Alcohol & Substance Abuse

_____

_____

_____

_____

18. M.D./R.D. "Team"

_____

_____

_____

_____

19. Enteral Nutrition Support

_____

_____

_____

_____

20. Parenteral Nutrition Support

_____

_____

_____

_____

21. Cultural/Ethnic Issues

_____

_____

_____

_____

23. Inborn Errors of Metabolism

_____

_____

_____

_____

24. Endocrine & Metabolic Disorders

_____

_____

_____

_____

 

Any Additional topics you would like to see covered in the series:

____________________________________________________

____________________________________________________

____________________________________________________

____________________________________________________

____________________________________________________

 

 

APPENDIX B

CONFIDENTIAL PATIENT NUTRITION SURVEY

1. Which doctor did you see today?     Name:___________________

2. Why were you here to see the doctor?

___ prenatal visit

 

___ physical/check-up

___ well child visit

___ other (list symptoms or diagnosis)

3. Was the purpose of your visit: ___ new ___ ongoing

4. Did your doctor give you:

___ handouts on nutrition/healthy eating?

___ handouts on a special nutrition topic? (i.e., sodium, cholesterol, fiber, osteoporosis)

___ a specific diet plan for you to follow:

___ low-calorie

___ low-fat

___ hi-fiber

___ renal

___ diabetic

___ low-cholesterol

___ low sodium

__ other

___ no nutrition handouts

5. Did your doctor discuss nutrition as part of your:

___ health maintenance plan (staying healthy)?

___ special health needs (treatment of a specific condition, such as diabetes, high-cholesterol, or high-blood pressure)?

___ neither

6. Did your doctor recommend that you:

___ see a dietitian/nutritionist?

___ attend a hospital-sponsored diet class?

___ contact one of the following community groups?

          ___ Women Infants & Children

___ Senior Dining Program

          ___ Weight Watchers

___ Expanded Food & Nutrition Program

          ___ Meals on Wheels

___ Other Weight-Loss Program

___ nutritional supplements (ie., vitamins, minerals, or "Ensure®" type products)

___ no nutrition recommendations

7. Did you ask your doctor any nutrition-related questions? ___Yes ___No

8. If yes to #7, did the doctor give you the information that you needed?

___ very complete/useful information

___ adequate information

___ information was not what I needed


Note: Ensure® is a registered trademark of Abbott Laboratories, Inc., Abbott Park, Illinois [U.S.]. The product name is used here to identify a class of diet supplement products. The mention of this product should not be interpreted as an endorsement or advertisement.

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